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Randomized Controlled Trial
. 2013 Oct;68(10):922-8.
doi: 10.1136/thoraxjnl-2012-203103. Epub 2013 Jun 4.

The effectiveness of a structured education pulmonary rehabilitation programme for improving the health status of people with moderate and severe chronic obstructive pulmonary disease in primary care: the PRINCE cluster randomised trial

Dympna Casey  1 , Kathy Murphy, Declan Devane, Adeline Cooney, Bernard McCarthy, Lorraine Mee, John Newell, Eamon O'Shea, Carl Scarrott, Paddy Gillespie, Collette Kirwan, Andrew W Murphy
Affiliations
Free PMC article
Randomized Controlled Trial

The effectiveness of a structured education pulmonary rehabilitation programme for improving the health status of people with moderate and severe chronic obstructive pulmonary disease in primary care: the PRINCE cluster randomised trial

Dympna Casey et al. Thorax. 2013 Oct.
Free PMC article

Abstract

Objective: To evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).

Design: Two-arm, cluster randomised controlled trial.

Setting: 32 general practices in the Republic of Ireland.

Participants: 350 participants with a diagnosis of moderate or severe COPD.

Intervention: Experimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.

Main outcome measure: Health status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12-14 weeks postcompletion of the programme.

Results: Participants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.

Conclusions: A primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.

Trial registration: ISRCTN52403063.

Keywords: Exercise; Pulmonary Rehabilitation.

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Figure 1
Figure 1
Patient eligibility identification algorithm. Access the article online to view this figure in colour.
Figure 2
Figure 2
Flow of participants and practices through trial. Access the article online to view this figure in colour.
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References

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    1. National Institute for Health and Clinical Excellence Guidance on the use of patient education models for diabetes. Technology Appraisal Guidance 60. NICE, 2003

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